Inspection on 21/09/07 for Acorn Hill Nursing Home

This inspection was carried out on 21st September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acorn Hill Nursing Home 10/06/09

Acorn Hill Nursing Home 10/07/08

Acorn Hill Nursing Home 12/04/07

Acorn Hill Nursing Home 12/04/06

Acorn Hill Nursing Home 02/09/05

Acorn Hill Nursing Home 15/04/05

Acorn Hill Nursing Home 02/09/04

Acorn Hill Nursing Home 28/01/04

Similar services:

Trevayler Residential Care Home

St Marys Nursing Home

Thornham Grove

Cheaney Court Care Home

Thistle Hill Hall

Chater Lodge

Conifer Lodge

Tixover Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Crown Hills Nursing Home Radstone Walk Rowlatts Hill Leicester LE5 4UH Lead Inspector Lesley Allison-White Key Unannounced Inspection 21st September 2007 10:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crown Hills Nursing Home Address Radstone Walk Rowlatts Hill Leicester LE5 4UH Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0116 2760600 0116 2761428 saidz@btinternet.com GB Care Ltd Mrs Sadie Jane Green Care Home 49 Category(ies) of Dementia - over 65 years of age (49), Learning registration, with number disability over 65 years of age (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (49) Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To be able to admit the named person of category LD named in variation application number V8757 dated 11/6/04 To be able to admit the named person of category DE as identified in variation application No. V7975 dated 2 June 2004 for periods of respite care. 12th April 2007 Date of last inspection Brief Description of the Service: Crown Hills Nursing and Residential Home is a care home offering accommodation for up to forty-nine older people. The home is registered to admit older people with dementia and/or mental disorders. The home is located in a residential area to the east of Leicester. It is easily accessed by road using the outer ring road. The centre of Leicester is approximately fifteen minutes away by car and there are adequate car parking spaces. A bus service is available from outside the home with more frequent bus services available near to the home. The buses Number 54 and Number 16 supply a service passing every ten minutes. The building itself is a purpose built modern property offering accommodation on three levels. The majority of rooms available are situated on the ground and first floors. The home is equipped with a slow moving lift. There is a large garden to the rear of the property with a lawned area, established plants and trees and a patio area with seating. All areas of the home and outside areas are accessible for people with mobility impairments. Fees range from £280.00 per week to £481.00 per week The current Employers Liability and The Commission for Social Care Inspection (CSCI) registration certificate are displayed in the office. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is on outcomes for residents and their views of the service provided. This was an unannounced inspection and took place on a Friday. The inspection focussed on checking existing records kept in the home, talking to residents, their relatives and the staff and observing care practices in some cases. There were thirty- nine residents at the home at this inspection. An Annual Quality Assurance Assessment form (AQQA, current information about the service) was received from the provider and the service history was used to plan this inspection. At this inspection not all the key National Minimum Standards were met. The Registered person facilitated this inspection. What the service does well: What has improved since the last inspection? The inspector spoke with a visiting nurse and she explained that a communication book is used and there is improvement by the care staff when carrying out instructions leading improved care of residents. One resident was observed receiving appropriate care by a carer who assisted the resident to eat their meal the carer demonstrated patience and understanding of the residents difficulties to swallow their meal. A Registered Nurse was seen advising two members of the care staff to use the hoist when they found that the resident was not standing well on the day. Carers were seen moving residents in specialised chairs one moving the chair the other guiding the chair and observing the resident’s legs to avoid injuries. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are made prior to anyone coming into Crown Hills for care. EVIDENCE: Two residents were case tracked at this inspection. Case tracking involves looking at the residents’ care and social records in detail. Health, social and mental care assessments were in place including weight records each month, moving and handling, bed rail assessment and relatives signatures obtained where necessary, food and fluid assessments, Waterlow (an assessment to show the general well being or frailty of a person), use of and review of any specialised equipment such as use of an air flow mattresses. Standard 6 intermediate care is not offered at this home. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are set out in their plans of care and improvements in carrying out the care are being made. EVIDENCE: Both care records of the two case tracked residents had an interagency sheet for contact with the General Practitioner (GP) and other medical staff in place. Accident forms were completed and entered into the resident’s records and any treatments being undertaken. District and Community Nurses visited residents who needed their input. The inspector spoke to a visiting nurse and she explained that a communication book is completed and this has lead to an improvement in the care staff carrying out instructions leading to the care of residents. One resident was observed receiving appropriate care by a carer who assisted the resident to eat their meal the carer demonstrated patience and understanding of the residents difficulties to swallow their meal. A Registered Nurse was seen advising two members of the care staff to use the hoist when Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 10 they found that the resident was not standing well on the day. Carers were seen moving residents in specialised chairs one moving the chair the other guiding the chair and observing the resident’s legs to avoid injuries. In this way improvements in care were seen. Please see the section on Staffing also. Medications of the two residents case tracked were checked and satisfactory. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities are provided at the home. However, staff must make greater efforts to ensure that residents have a meaningful day. EVIDENCE: Care activities are included in the residents’ case tracked plans of care. However the activity coordinator was unable to attend work on the day of inspection and the notice board listed a general activity of reading the newspaper by staff to the residents and putting on a film. Two residents who spoke to the inspector said that they did not feel that there were enough activities for them to do and felt bored. Residents were seen sitting quietly in small groups doing nothing other residents were seen wandering around the home without a sense of purpose. A relative who spoke with the inspector explained that they were free to visit whenever they wanted to and took their relative out on a regular basis. They said that they found the staff helpful and polite and had no cause for concern. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 12 Religious and cultural needs are supported through the use of local churches or other places of worship. A mealtime was seen. Residents appeared to enjoy their meal and those who spoke with the inspector said that they enjoyed the meals provided for them. Specialist diets are provided for residents who need this. Staff was seen assisting residents who needed assistance. Family members were also present assisting their relatives at the mealtime. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are aware of the need to protect residents from harm and feel able to seek appropriate advice or help to do so. EVIDENCE: A complaint has been received about Crown Hills to CSCI. This has been dealt with. Relatives and residents who spoke with the inspector said that they would know who to go to if they had a concern or a complaint. The Registered Manager runs a forum for relatives and residents to attend where they can express any concerns that they may have. Staff are aware of how to assist a resident or relative should they wish to make a complaint. The majority of staff who spoke with the inspector was aware of methods used for the Protection Of Vulnerable Adults (POVA) and further training is being offered during the year for all staff. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and pleasant. EVIDENCE: The lighting upstairs was on and provided sufficient light for residents who wandered around the home. The maintenance person is still employed and continues to carry out his duties in the area of Health and Safety and in the general presentation of the home. Staff needs to be more aware of the environment in which they work to maintain a homely environment for the residents to live in. When small items need repairing they should be reported promptly, in this way staff will provide an essential role in the maintenance of the environment. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 15 The Registered Manager explained that she continues to monitor the level of cleanliness within the home and continues to recruit staff to work in this area. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff at Crown Hills must learn to put their learning into practice at all times when carrying out care for the residents. EVIDENCE: Staff were observed giving care however there were times when they missed opportunities. Residents were observed to wear un matching slippers, staff were seen to startle residents who were sleeping in one of the lounges by their approach, residents were seen whose feet did not touch the ground and the assistance of a foot stool or soft pillow would make the resident more comfortable. Staff at Crown Hills continues to receive training as necessary for their daily roles and responsibilities but fail to link training with practice. This was discussed with the Registered Manager and as a way forward regular staff meetings learning from role-play will form part of the staffs’ regular learning pattern. In this way, genuine improvements in the care of residents will result. This will be a recommendation. Staff and residents come from various culturally diverse backgrounds; there are no issues of concern. Staff records were checked and satisfactory. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 17 The Registered Nurses must continue to supervise and correct poor practice as part of their monitoring role for care given to residents. This will be a requirement. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Provider continues to ensure that the home is run in the best interests of the residents. EVIDENCE: The Registered Manager continues to monitor residents’ finances. Families, advocates or the residents’ themselves are given the opportunity to manage their own finances wherever possible. One resident’s records was checked and found to be satisfactory. Health and Safety records are kept up to date. The home continues to monitor the quality within its service through the use of questionnaires and meetings with residents, their relatives and staff. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 13 (4) © Requirement The Registered Nurses must ensure that as part of their supervisory role they monitor the care given to residents by care staff and correct it as required. Timescale for action 21/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30 Good Practice Recommendations The use of role-play to enhance learning is recommended. Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Crown Hills Nursing Home DS0000001897.V351154.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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